Odds Rations Research Articles

Impact of socioeconomic status on cardiac arrest outcomes during COVID-19 pandemic

IntroductionThe coronavirus disease 19 (COVID-19) pandemic has affected healthcare services, potentially leading to inequitable outcomes based on patients’ socioeconomic status (SES). This study aimed to evaluate the impact of COVID-19 on out-of-hospital cardiac arrest (OHCA) outcomes by examining disparities across SES levels. MethodsThe study analyzed non-traumatic OHCA cases registered in the Korean Out-of-Hospital Cardiac Arrest Registry from 2010 to 2021, encompassing 238,668 patients aged 18 years and older. SES was assessed at both the individual (Medicaid vs non-Medicaid) and area levels using a deprivation index. Outcomes included any return of spontaneous circulation, survival to admission, survival to discharge, and favorable neurological recovery. Logistic regression and generalized additive models (GAMs) were used for analysis. ResultsOHCA outcomes—including survival to admission, survival to discharge, and favorable neurological recovery—improved over the years, peaking in 2019 before subsequently declining. Logistic regression showed that the lowest SES area was associated with lower rates of ROSC (adjusted odds rations [aOR] 0.82, 95 % confidence interval [CI] 0.75–0.88) and survival to admission (aOR 0.56, 95%CI 0.49–0.64) and discharge (aOR 0.78, 95%CI 0.61–0.98) during the pandemic. GAM analysis revealed that lower SES groups (deprivation index levels 4 and 5) experienced higher-than-expected survival to admission and discharge rates, as well as favorable neurological recovery. Although outcomes in the deprivation index level 1 group (5.5 % in 2021) remained superior, indicating poor outcomes for the lowest SES area group (3.43 % in 2021), the disparity decreased following the pandemic. ConclusionLower levels of SES are a significant risk factor for unfavorable neurological recovery in OHCA, independent of the COVID-19 pandemic. However, SES-related disparities in the outcomes decreased post-pandemic. Despite the overall negative impact of COVID-19, certain lower SES groups showed improved survival rates, likely due to differences in the EMS response and healthcare burden across regions.

A higher body mass index and increased syndesmophytes volume are associated with facet joints ankylosis on thoracic spine in patients with ankylosing spondylitis: a retrospective cohort study

ObjectiveTo investigate the association between syndesmophytes and facet joint (FJ) lesions in patients with ankylosing spondylitis (AS), and to identify clinical factors associated with FJ ankylosis (FJA) in thoracic segment.MethodsNinety-seven patients with AS who underwent thoracic spine computed tomography (CT) or chest CT and without completely thoracic spine fusion were included. FJ lesions were analyzed for the numbers and distribution of normal, ankylosis, erosions, joint-space narrowing, osteophytes, and subchondral sclerosis. The volume of vertebral syndesmophtes unit (VSU) and total thoracic syndesmophtes volume were separately calculated by Mimics software. Clinical factors associated with FJA were investigated using generalized estimation equation (GEE). The association between syndesmophtes volume and numbers of FJ structural lesions was analyzed using generalized additive mixed model (GAMM).Results2328 FJ and 1164 VSUs in thoracic spine were assessed. The majority FJ structural lesions were ankylosis (32.39%). FJA was more frequently seen in vertebrae with syndesmophytes formation (p < 0.001). GEE showed that patients with normal BMI (18.5–24.9 kg/m2) and high BMI (> 24.9 kg/m2) were more likely to have FJA in thoracic spine (odds rations [95% confidence interval]: 0.27(0.12–0.59), 1.45(1.03–8.57), respectively). GAMM showed that syndesmophytes volume increase the numbers of FJA (standard β = 0.009, p < 0.05) and decreased the numbers of normal FJ (standard β = -0.07, p < 0.01).ConclusionFJA was the most common FJ structural lesion in thoracic spine, and it increases linearly with syndesmophytes before the bridging syndesmophytes formed. A higher BMI (especially > 24.9 kg/m2) and increased syndesmophytes volume are associated with FJA in thoracic spine.

Prediction of Readmission Following Sepsis Using Social Determinants of Health.

To determine the predictive value of social determinants of health (SDoH) variables on 30-day readmission following a sepsis hospitalization as compared with traditional clinical variables. Multicenter retrospective cohort study using patient-level data, including demographic, clinical, and survey data. Thirty-five hospitals across the United States from 2017 to 2021. Two hundred seventy-one thousand four hundred twenty-eight individuals in the AllofUs initiative, of which 8909 had an index sepsis hospitalization. None. Unplanned 30-day readmission to the hospital. Multinomial logistic regression models were constructed to account for survival in determination of variables associate with 30-day readmission and are presented as adjusted odds rations (aORs). Of the 8909 sepsis patients in our cohort, 21% had an unplanned hospital readmission within 30 days. Median age (interquartile range) was 54 years (41-65 yr), 4762 (53.4%) were female, and there were self-reported 1612 (18.09%) Black, 2271 (25.49%) Hispanic, and 4642 (52.1%) White individuals. In multinomial logistic regression models accounting for survival, we identified that change to nonphysician provider type due to economic reasons (aOR, 2.55 [2.35-2.74]), delay of receiving medical care due to lack of transportation (aOR, 1.68 [1.62-1.74]), and inability to afford flow-up care (aOR, 1.59 [1.52-1.66]) were strongly and independently associated with a 30-day readmission when adjusting for survival. Patients who lived in a ZIP code with a high percentage of patients in poverty and without health insurance were also more likely to be readmitted within 30 days (aOR, 1.26 [1.22-1.29] and aOR, 1.28 [1.26-1.29], respectively). Finally, we found that having a primary care provider and health insurance were associated with low odds of an unplanned 30-day readmission. In this multicenter retrospective cohort, several SDoH variables were strongly associated with unplanned 30-day readmission. Models predicting readmission following sepsis hospitalization may benefit from the addition of SDoH factors to traditional clinical variables.

Predictors of Postpartum Hemorrhage and Associated Outcomes at a Midwest Academic Medical Center.

Postpartum hemorrhage (PPH) remains a significant cause of maternal morbidity and mortality around the world, with rates increasing in the United States. The objective of this study was to determine predictors of, and outcomes associated with, PPH at a Midwest academic health center. Demographic and clinical data were obtained from the electronic medical record on all consecutive delivering patients between May 1, 2020, and April 30, 2021. Associations between PPH and perinatal characteristics and outcomes were assessed using logistic regression models. A significance threshold of 0.05 was used for all comparisons. Of the 2497 delivering patients during the study period, 437 (18%) experienced PPH. Chronic hypertension, gestational hypertension, and preeclampsia with and without severe features were all associated with increased odds of PPH (odds rations [ORs], respectively, 1.61 (95% CI:1.13-2.24, p = 0.006), 1.62 (95% CI 1.18-2.21, p = 0.003), 1.81 (95% CI 1.14-2.80, p ≤ 0.001), and 1.92 (95% CI 1.29-2.82, p = 0.009). There were also increased odds of PPH with type I diabetes: 2.83 (95% CI 1.45-5.30, p = 0.001), type II diabetes: 2.14 (95% CI 1.15-3.82, p = 0.012), twin delivery: 3.20 (95% CI 2.11-4.81, p ≤ 0.001), cesarean delivery: 5.66 (95% CI 4.53-7.09, p ≤ 0.001), and assisted vaginal delivery: 3.12 (95% CI1.95-4.88, p ≤ 0.001). Infants of mothers with PPH had high odds of NICU admission (CI = 1.34-2.07, p < 0.001) and hypoxic ischemic encephalopathy (CI = 1.64-7.14, p < 0.001). Our findings confirm previous literature that preexisting and pregnancy-related hypertension, diabetes mellitus, multiple gestation, cesarean delivery, and assisted vaginal delivery are important predictors of PPH. In addition, we found that neonates of mothers with PPH had more adverse outcomes. These results may help to inform clinical care as rates of PPH continue to rise in the United States.

Association between National Area Deprivation Index Rank on Disease Characteristics in Prostate Cancer

Social determinants of health (SDH) play a large role in an individual's health; in recent years, there has been a push to examine the impact of one's neighborhood or "place." Previous studies have showed that living in a disadvantage neighborhood is associated with worth health outcomes. We hypothesize that equal access care will diminish the effects of living in a disadvantaged neighborhood. We identified non-Hispanic African American (AA) and White (NHW) men diagnosed with PC between 2012 and 2015 in the Veterans Health Administration (VHA). Patient SDH was measured using census tract level 2015 Area Deprivation Index (ADI) information. The ADI is a composite measure that includes factor such as housing quality, income, health care access etc. We measured both National and State ADI rank as a continuous variable from 1 to 10 with 10 being highest deprivation. Patient information was gathered at the census tract level while ADI is assigned at the census block group. In order to get all information on the same geographic level, we averaged the ADI to its corresponding census tract. Associations between ADI and disease characteristics at diagnosis were measured using multivariable logistic regression models including age, race, and marital status as covariates. The final cohort was composed of 25,222 men (8,384 AA and 16,838 NHW.) At the national level, there was no significant association between ADI and Gleason Score ≥8 (Odds Rations (OR) 0.99 [95% Confidence Interval (CI):0.98 - 1.00]), PSA >20 ng/mL (OR 0.99 [95% CI: 0.98 - 1.01]), and metastasis at diagnosis (OR 1.01 [CI: 0.98-1.04]). Our results are consistent with our hypothesis that equal access care diminishes the impacts of living within a disadvantaged neighborhood. Future research should investigate the interaction between health care access and social and demographic factors.

Maternal Malnutrition During Pregnancy Among Women with Metabolic and Bariatric Surgery.

As the utilization of metabolic and bariatric surgery (MBS) continues to rise, it is important to address the nutritional needs of women who had MBS who become pregnant. Not meeting those nutritional needs could lead to complications associated with malnutrition. To better understand the relationship between MBS, pregnancy, and malnutrition, this study sought to determine whether differences exist in the presence of malnutrition during pregnancy in women with a history of MBS compared to women without a history of MBS. This cross-sectional study used the National Inpatient Sample (NIS) from 2012 to 2017, which samples 20% of hospital discharges in the USA. Multivariate logistic regression models were fitted, and odds rations and 95% confidence intervals were calculated with obesity and MBS as the independent variables and malnutrition during pregnancy as the dependent variable. Covariates included in the multivariate model were age, primary payer, hypertension, hyperlipidemia, and depression. Compared to women who did not have MBS, women who had MBS had higher odds of malnutrition during pregnancy (aOR = 8.33, 95% CI 7.30-9.50), this result was moderated by racial category (aORBlack = 6.35, 95% CI 4.97-8.13; aORwhite = 8.25, 95% CI 7.00-9.73; aORLatina = 10.93, 95% CI 8.38-14.25). Women with obesity also had higher odds of malnutrition during pregnancy. The increased odds of malnutrition among women with MBS suggests that it is important to consider tailoring nutrition recommendations to address the different nutritional needs of pregnant women who had MBS and may be at risk for malnutrition.

Fetal sex and the development of gestational diabetes mellitus in polycystic ovarian syndrome gravidae

Polycystic ovarian syndrome is characterized by elevated androgens and is a well-known risk factor for the occurrence of gestational diabetes mellitus. Androgens (particularly dehydroepiandrosterone-sulfate) are crucial for the development and characteristics of the male reproductive tract during fetal life, and fetal dehydroepiandrosterone-sulfate enters the placenta where it is metabolized and functions as an estrogen substrate. Given this unique sex-specific relationship with androgens and the association of serum dehydroepiandrosterone-sulfate concentration with insulin resistance, we hypothesized that metabolic comorbidities in pregnancy might differ by fetal sex in gravidae with polycystic ovarian syndrome, notably in those with infertility. This study aimed to evaluate the data in a large population-based database to explore if fetal sex was significantly associated with gestational diabetes mellitus in gravidae with infertility and polycystic ovarian syndrome after controlling for confounders. This study was designed to evaluate the risk for the occurrence and rates of gestational diabetes mellitus among gravidae with infertility and a history of polycystic ovarian syndrome. We used a 2-hospital, single academic institution database comprising more than 30,000 subjects enrolled from September 2011 to June 2021 to identify all gravidae with diagnoses of infertility and polycystic ovarian syndrome at the time of delivery and to compare them with gravidae who lacked these comorbidities. Data on covariates, including but not limited to maternal age, body mass index, fetal sex, race, ethnicity, presence or absence of hypertensive disease, and presence or absence of gestational diabetes were identified. Unadjusted and adjusted odds rations were calculated. We found a statistically significant association between fetal female sex and the development of gestational diabetes mellitus in gravidae with polycystic ovarian syndrome (odds ratio for female vs male, 2.13; 95% confidence interval, 1.06-4.32; P=.03). After adjusting for potential confounders identified in our univariate analyses, there continued to be a statistically significant association between female fetuses and the development of gestational diabetes mellitus (adjusted odds ratio for female vs male, 2.10; 95% confidence interval, 1.04-4.41; P=.04). In contrast, there was no significant association between fetal sex and the development of gestational diabetes mellitus in our similar analysis of gravidae without infertility and polycystic ovarian syndrome (P=.99). Although the origin of gestational diabetes mellitus is multifactorial, we found that female fetal sex is associated with gestational diabetes mellitus in gravidae with infertility and polycystic ovarian syndrome but not in their comparative controls. Further research on the molecular mechanisms driving the association between female fetuses and the development of gestational diabetes mellitus in the context of maternal polycystic ovarian syndrome is warranted.

Abstract 12680: Alcohol Consumption and Arrhythmia Recurrence After Atrial Fibrillation Ablation: A Systematic Review and Meta-Analysis

Introduction: Whether alcohol consumption increases the risk of atrial fibrillation (AF) recurrence following catheter ablation for AF remains unclear. We aimed to systematically review the medical literature to assess the impact of alcohol consumption on the recurrence of AF following AF Hypothesis: Elevated levels of alcohol consumption are associated with increased rates of AF recurrence following AF ablation. Methods: A structured electronic database search (MEDLINE, EMBASE, CONTROL; inception - December 2021) of the scientific literature was performed for studies reporting rates of AF recurrence following catheter ablation stratified by patients’ level of alcohol consumption. Alcohol use was dichotomized into categories which represented moderate-heavy alcohol use or those that represented abstention or rare alcohol use. Study specific odds rations (ORs) were meta-analyzed using a random effects model. Risk of bias was evaluated using the ROBINS-I tool. Results: A total of nine observational studies were identified, which included 5436 patients undergoing catheter ablation. There was substantial variation in the categories used to stratify alcohol consumption. Compared to patients consuming little to no alcohol, patients consuming moderate to high amounts of alcohol had a greater odds of AF recurrence (OR 1.45 [95% CI: 1.06-1.99, p = 0.02]; I 2 = 79%). This relationship remained significant after exclusion of studies with &lt; 100 participants (OR 1.40, 95% CI 1.03-1.90, p = 0.03) and when abstract-only publications were excluded (OR 1.84, 95% CI 1.21-2.80, p = 0.004). All included studies were found to be at serious risk of bias, mainly due to confounding. There was no evidence of publication bias. Conclusions: Increased alcohol consumption is associated with increased rates of AF recurrence following catheter ablation for AF. Reduction of alcohol consumption post ablation may reduce AF recurrence.

Perceived Risk of HIV Infection and Acceptability of PrEP among Men Who Have Sex with Men in Brazil.

The HIV epidemic affects men who have sex with men (MSM) disproportionally in Brazil, and pre-exposure prophylaxis (PrEP) is effective for preventing HIV in this population. However, low perceived risk of HIV may influence the acceptability and decision to use PrEP. This study estimated the association between self-perception of HIV risk and acceptability of daily oral PrEP among Brazilian MSM. Respondent-driven sampling (RDS) was used for behavioral and biological surveillance to recruit 4,176 MSM 18 years or over in 12 Brazilian cities in 2016. Results were weighted using Gile’s estimator in RDS Analyst software. Adjusted odds rations (OR) with 95% confidence intervals were calculated using multivariate logistic regression. Acceptability of daily oral PrEP was high (69.7%) among the 3,544 MSM available for analysis. Most participants self-reported low or moderate risk of HIV infection (67.2%) and a small proportion (9.3%) reported high risk. A dose–response relationship was observed between acceptability of PrEP and self-reported risk: PrEP acceptability was 1.88 times higher (OR 1.8; 95% CI: 1.24–2.85) among MSM whose perceived risk of HIV infection was low or moderate, and 5 times higher (OR 5.68; 95% CI: 2.54–12.73) among those who self-reported high risk compared to MSM reporting no HIV risk. MSM with the highest risk perception of HIV reported higher rates of PrEP acceptability. Given the availability of daily oral PrEP in the public health care system in Brazil, we suggest emphasizing counseling about self-perception of HIV risk as part of routine HIV prevention services.

Intent among Parents to Vaccinate Children before Pediatric COVID-19 Vaccine Recommendations, Minnesota and Los Angeles County, California-May-September 2021.

Objectives: This study assessed the associations between parent intent to have their child receive the COVID-19 vaccination, and demographic factors and various child activities, including attendance at in-person education or childcare. Methods: Persons undergoing COVID-19 testing residing in Minnesota and Los Angeles County, California with children aged <12 years completed anonymous internet-based surveys between 10 May and 6 September 2021 to assess factors associated with intention to vaccinate their child. Factors influencing the parents’ decision to have their child attend in-person school or childcare were examined. Estimated adjusted odds rations (AORs, 95% CI) were computed between parents’ intentions regarding children’s COVID-19 vaccination and participation in school and extra-curricular activities using multinomial logistic regression. Results: Compared to parents intending to vaccinate their children (n = 4686 [77.2%]), those undecided (n = 874 [14.4%]) or without intention to vaccinate (n = 508 [8.4%]) tended to be younger, non-White, less educated, and themselves not vaccinated against COVID-19. Their children more commonly participated in sports (aOR:1.51 1.17–1.95) and in-person faith or community activities (aOR:4.71 3.62–6.11). A greater proportion of parents without intention to vaccinate (52.5%) indicated that they required no more information to make their decision in comparison to undecided parents (13.2%). They further indicated that additional information regarding vaccine safety and effectiveness would influence their decision. COVID-19 mitigation measures were the most common factors influencing parents’ decision to have their child attend in-person class or childcare. Conclusions: Several demographic and socioeconomic factors are associated with parents’ decision whether to vaccinate their <12-year-old children for COVID-19. Child participation in in-person activities was associated with parents’ intentions not to vaccinate. Tailored communications may be useful to inform parents’ decisions regarding the safety and effectiveness of vaccination.

Symptomatic Joint Hypermobility Is Associated with Low Back Pain: A National Adolescents Cohort Study.

Background: Low back pain (LBP) is a widespread medical complaint affecting many people worldwide and costing billions. Studies suggest a link between LBP and joint hypermobility. This study aimed to examine the association between symptomatic joint hypermobility (SJH), LBP, and gender. Methods: Data were obtained from a medical database containing 17-year-old candidates’ records before recruitment into mandatory military service. According to the Regulations of Medical Fitness Determination, information on disability codes associated with LBP and SJH was retrieved. Results: According to this national survey, the prevalence of SJH is 0.11% (1355 cases out of 1,220,073 subjects). LBP was identified in 3.7% of the cohort (44,755 subjects). Subjects were further subdivided into LBP without objective findings (LBPWF) (3.5%) and LBP with objective findings (LBPOF) (0.2%). The association between SJH and LBP was examined: the Odds Ratio (OR) was 2.912 (p < 0.0001). The odds rations for LBPWF and LBPOF were further calculated to be 2.914 (p < 0.000) and 2.876 (p < 0.000), respectively. Subjects with SJH were almost three times more prone to LBPWF and LBPOF. Conclusion: SJH is strongly associated with LBP in young adults. Further pathophysiological research is needed.

Environmental Risk Factors for Childhood Inflammatory Bowel Diseases: A Multicenter Case-Control Study.

Objective: Multiple environmental factors can be linked to the development of inflammatory bowel disease (IBD). With an increase in the cases of IBD, the objective of this research is to investigate environmental risk factors for IBD in the Saudi population. Methods: A retrospective multicenter case–control study was performed among IBD children from 2009 to 2021.The variables analyzed to be the possible risk factors included their socioeconomic status, living and demographic characteristics, and lifestyle related to IBD. The questionnaire included a list of IBD risk factors that was given to the control and the patient group. For every variable, the 95% confidence interval (CI) and odds rations were also estimated. Results: There were 335 individuals considered in this study: 168 controls (50.1%) and 167 IBD patients (49.9%). Of these, 93 IBD patients (56%) had CD and 74 patients (44%) had UC. Most of participants were female (72.1%) and were aged above 10 years (51.5%). Vaginal delivery (OR 0.551, 95% CI: 1.59–4.14), age above 10 years (OR 1.040, 95% CI: 1.012–1.069), deficient fruit intake (OR 2.572, 95% CI: 1.59–4.14), no exposure to antibiotics (OR 2.396, 95% CI: 1.51–3.81), appendectomy (OR 2.098, 95% CI: 1.87–2.35), less physical activity (OR 2.033, 95% CI: 1.05–3.93) and gastroenteritis admissions > 2 times/year (OR 0.107, 95% CI: 0.037–0.311) were the risk factors for IBD. These factors depicted a more significant link with CD than UC (p < 0.05). Interestingly, sleep disturbance was estimated to be a CD risk factor (adjusted OR: 3.291, 95% CI = 0.97–11.22). Pets in house was risk factor for UC (p < 0.001). Conclusions: This study highlights association between vaginal delivery, age above 10 years, deficient fruit intake, low physical activity, exposure to antibiotics, appendectomy, and frequent gastroenteritis admissions as risk factors for IBD. Knowledge of these risk factors can help pediatricians to prospectively identify patients at risk of environmental exposure.

Predictors of Suicide Ideation and Attempt Planning in a Large Sample of New Zealand Help-Seekers.

AimSuicide is a major public health concern worldwide. The present study explores the risk factors for suicide ideation and suicide attempt planning by analyzing anonymized data collected by a New Zealand telephone helpline.MethodA nation-wide helpline, Lifeline Aoteroa, provided data from distressed callers obtained from May 2017 to April 2018. The analyzed sample consisted of 32,889 counseling calls of clients with a wide range of presenting issues. Frequency analysis and multivariable logistic regression were adopted to determine risk and protective factors associated with two types of suicide behaviors: suicide ideation and suicide planning.ResultsRisk factors for suicide ideation and suicide planning included: hopelessness, sadness, fear, not coping with symptoms of mental health issues, mild/moderate severity self-harm, severe self-harm, urge to self-harm, alcohol and/or drug addiction, suicide in family, sexual domestic abuse. The adjusted odds rations for these risk factors ranging from 1.31 to 16.42. Protective factors included feelings of hope or joy, the opportunity to talk and, unexpectedly, feeling anxious or stuck. The adjusted odds ratios for protective factors ranged from 0.15 to 0.75.ConclusionRisk factors were identified for both suicide ideation and for suicide attempt planning. While some of these risk factors have been reported in existing literature, there are also risk factors unique to the present study that could inform and improve suicide-screening procedures administered by clinicians or helplines.

The association between growth patterns and blood pressure in children and adolescents: A cross-sectional study of seven provinces in China.

Aimed to investigate the associations between different growth patterns with high blood pressure, and further examine the mediation effect of BMI between growth patterns and high blood pressure among children and adolescents. A total of 31581 children and adolescents aged 7–18 years were selected based on the stratified cluster sampling method. Logistics regression models were used to calculate the odds rations (ORs) and 95% confidence interval (95%CI) of the association between different growth patterns and high blood pressure. Mediation effect analyses were applied to estimate the effect of BMI on the increase of blood pressure levels in different growth patterns. In different sex and ages, compared to reference group of normal growth, blood pressure levels and prevalence of high blood pressure of the catch‐up growth were higher, but that of the catch‐down growth were lower. The prevalence of high blood pressure was 11.69%, 16.06%, and 9.68% in normal growth, catch‐up growth, and catch‐down growth, respectively. In total, compared with the normal growth pattern, the ORs (95%CI) of high blood pressure, high systolic blood pressure and high diastolic blood pressure in the catch‐up growth were 1.171(1.073,1.280), 1.110(1.001,1.230) and 1.141(1.025,1.270) (p < .05), respectively. Additionally, the mediation effect of current BMI existed in the association between blood pressure levels and different growth patterns, particularly in boys. Our findings suggested that different growth patterns after birth could modify blood pressure, and the potential risks of high blood pressure could be increased by catch‐up growth at childhood and adolescence.

ATP2B1 gene polymorphisms rs2681472 and rs17249754 are associated with susceptibility to hypertension and blood pressure levels: A systematic review and meta-analysis.

Objective:The present study aimed to conduct a systematic review and meta-analysis to evaluate the relationships between ATP2B1 gene polymorphisms with blood pressure (BP) level and susceptibility to hypertension.Methods:PubMed, Web of Science, Embase and China National Knowledge Infrastructure (CNKI) Databases were systematically searched by 2 independent researchers to screen studies on ATP2B1 gene polymorphisms and BP related phenotypes. The records retrieval period was limited from the formation of the database to March 4, 2021. Pooled odds rations (ORs) or β and their 95% confidence intervals (95%CI) were calculated to assess the association between ATP2B1 gene polymorphisms and the risk of hypertension or BP levels. Publication bias and sensitivity analysis were conducted to find potential bias. All the statistical analysis were conducted with Stata version 11.0 software.Results:A total of 15 articles were ultimately included in the present study, including 15 polymorphisms of ATP2B1 gene. Nine articles (N = 65,362) reported the polymorphism rs17249754, and 7 articles(N = 91,997) reported rs2681472 (both loci were reported in 1 article). Meta-analysis showed that rs17249754 (G/A) and rs2681472 (A/G) were associated with the susceptibility to hypertension (rs17249754: OR = 1.19, 95%CI: 1.10–1.28; rs2681472: OR = 1.15, 95%CI: 1.12–1.17), and were positively associated with systolic BP (SBP) and diastolic blood pressure (DBP) (rs17249754: SBP, β=1.01, 95%CI: 0.86–1.16, DBP, β=0.48, 95%CI: 0.30–0.66; rs2681472: SBP, β=0.92, 95%CI: 0.77–1.07, DBP, β=0.50, 95%CI: 0.42–0.58) in the additive genetic model. Subgroup analysis stratified by race, population, sample size, and BP measurement method revealed that the association between A allele in rs2681472 polymorphism and risk of hypertension was slightly stronger in European (EUR) populations (OR = 1.16, 95%CI: 1.13–1.20) than in East Asians (OR = 1.14, 95%CI: 1.10–1.17). While in East Asians, relation between rs17249754 with risk of hypertension (OR = 1.19, 95%CI: 1.10–1.28) is stronger than rs2681472 (OR = 1.14, 95%CI: 1.10–1.17).Conclusions:Our study demonstrated that ATP2B1 gene polymorphism rs2681472 and rs17249754 were associated with BP levels and the susceptibility to hypertension.

The role of estrogen receptor-beta gene +1730G/A polymorphisms in recurrent pregnancy loss: A protocol for systematic review and meta-analysis.

Objective:To identify the role of estrogen receptor-beta (ER-β) gene +1730G/A (rs4986938) polymorphisms in recurrent pregnancy loss (RPL).Methods:All relevant case-control studies will be systematically searched in multiple databases including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Internet (CNKI), Wanfang and Cqvip. Both pooled odds rations (ORs) and 95% confidence intervals (CIs) will be used to assess the association between ER-β gene +1730G/A polymorphisms and RPL risk. The publication bias will be evaluated using Egger test.Results:ER-β gene +1730G/A variation may be associated with a higher risk of RPL in Caucasian population.Conclusions:The findings of this meta-analysis will provide high-quality evidence for the association between ER-β gene +1730G/A polymorphisms and RPL, facilitating clinical practice and further scientific studies.OSF registration number:10.17605/OSF.IO/EW9FB.

Novel and traditional anthropometric indices for identifying metabolic syndrome in non-overweight/obese adults

BackgroundMetabolic syndrome (MetS) in non-overweight/obese people is insidiously associated with cardiovascular disease. Novel anthropometric indices can reflect central obesity better than the traditional anthropometric indices. Therefore, we hypothesize that these newly developed anthropometric indices can better identify MetS in non-overweight/obese people than conventional indices.MethodsCross-sectional data of sociodemographic, biochemical and anthropometric indices were collected from 2916 non-overweight/obese Chinese people. A body shape index (ABSI), body roundness index (BRI), waist-to-height ratio (WHtR), weight-adjusted-waist index (WWI) and abdominal volume index (AVI) were calculated. Partial correlation analysis was used to clarify the correlation between anthropometric indices and MetS variables. Binary logistic regression analysis was applied to assess the association between anthropometric indices and MetS and its components. Receiver-operating characteristic curve was used to identify the diagnostic ability of anthropometric indices for MetS and its components. The area under curve (AUC) difference between WHtR and each new anthropometric index was compared in pairs.ResultsAfter adjusting for covariates, AVI had the optimal ability of identifying MetS (AUC: 0.743 for male, 0.819 for female) and the strongest correlation with high-density lipoprotein cholesterol (HDL-C) (coe: − 0.227 for male, − 0.207 for female) and the highest odds rations (OR) with low HDL-C group (male: OR = 1.37, female: OR = 1.55). The WHtR was comparable to BRI in assessing MetS (AUC: 0.739 for male, 0.817 for female). WHtR or BRI could also well identify hypertension (AUC: 0.602 for male, 0.688 for female) and dysglycemia (AUC: 0.669 for male, 0.713 for female) and female’s high triglyceride level (AUC 0.712). The recognition ability of the two was equivalent. The ability of ABSI and WWI to identify MetS was weak.ConclusionsAVI is the optimal anthropometric indices to identify MetS in non-overweight/obese Chinese adults. BRI and WHtR can also be considered as discriminators, while ABSI and WWI are weak discriminators. WHtR is easy to measure. So, it is recommended as an early preliminary screening method for the MetS in non-overweight/obese people.

Pelvic floor muscle training in the treatment of pelvic organ prolapse: A meta-analysis of randomized controlled trials

BackgroundWe aimed to assess the overall effect of pelvic muscle training (PFMT) on patients with pelvic organ prolapse (POP) based on eligible randomized controlled trials (RCT). MethodsWe searched the following databases, such as PubMed, Cochrane, and Embase, to identify eligible RCT based on the index words updated to December 2018. We also searched the publications related to the present study. Odds rations (OR), and mean difference (MD) along with 95% confidence interval (95%CI) were used to analyze the main outcomes. ResultsIn this meta-analysis, 15 RCTs were included with a total of 1309 patients in the PFMT group and a total of 1275 patients in the control group. The overall results showed no significant difference in the incidence of add 2 POP-Q stages (RR: 0.55, 95%CI: 0.19–1.63), add 1 POP-Q stages (RR: 1.04, 95%CI: 0.69–1.57), no POP-Q stages change (RR: 0.94, 95%CI: 0.81–1.09), reduce 2 POP-Q stages (RR: 1.72, 95%CI: 0.79–3.76), self-reported same symptom change (RR: 0.70, 95%CI: 0.45–1.09), and self-reported worse symptom change (RR: 0.67, 95%CI: 0.22–2.03) between the 2groups. Besides, the incidence of reduce 1 POP-Q stages was significantly higher in the PFMT group than that of the control group (RR: 1.80, 95%CI: 1.20–2.69), and the PFMT significantly changed the self-reported symptoms with better outcomes when compared with the control group (RR: 2.90, 95%CI: 1.72–4.89). However, after the therapy, the PFMT group decreased the POP-SS (SMD: −0.24, 95%CI: −0.71 to 0.22), POPDI-6 (SMD: −0.14, 95%CI: −0.43 to 0.15), CRADI-8 (SMD: −0.03, 95%CI: −0.16 to 0.11), and UDI-6 (SMD: −0.17, 95%CI: −0.43 to 0.10) versus the control group, but without statistical significance. ConclusionPMFT showed better effect in reducing 1 POP-Q stages, changing the self-reported symptoms with better outcomes, decreasing the score of POP-SS, POPDI-6, CRADI-8, and UDI-6 in women with POP versus the control group. However, more high-quality multicenter RCTs with a larger sample size are needed to confirm the present conclusions.

A review of prenatal HIV screening practices among physicians at a tertiary care center in Lebanon: is it culture?

ABSTRACT HIV remains one of the major causes of mortality and morbidity among women of reproductive age; given the risk of vertical transmission to the fetus, timely prevention, monitoring and management are imperative (Melaku et al. [2014]. Causes of death among females-investigating beyond maternal causes: A community-based longitudinal study. BMC Research Notes, 7(1), 629. https://doi.org/10.1186/1756-0500-7-629). Most HIV studies in Lebanon focus on men who have sex with men, people diagnosed with sexually transmitted infections, intravenous (IV) drug users, and people infected by blood transfusion products Ministry of Public Health [2017]. National AIDS Control Program in Lebanon. https://www.moph.gov.lb/en/Pages/2/4000/aids#/en/Pages/2/4000/aids; Shaheen [2014]. Around 3,750 HIV/AIDS cases in Lebanon. The Daily Star. https://www.dailystar.com.lb/News/Lebanon-News/2014/Dec-02/279570-around-3750-hivaidscases-in-lebanon.ashx). We conducted a retrospective review of women who delivered at a tertiary academic hospital in Beirut between January 2016-Decemeber 2017 to assess prenatal HIV screening practices. In total, 1500 charts were randomly selected and reviewed: 137 (9%) women were screened for HIV, 2 (1.5%) tested positive. Odds rations were calculated for screening in relation to religion, parity, previous abortions, and mode of delivery: none were significant. No one was tested for Gonorrhoea and Chlamydia; 1250 (93.8%) were tested for Hepatitis B, 27 (1.9%) for Hepatitis C, 7 (0.5%) for HSV and, 74(5.3%) for Syphilis. Barriers to screening may include: Lack of consensus on mandated screening policy, HIV stigma, physician and patient prejudice and misconception of risk and, financial barriers as health insurance does not cover HIV screening.

Thirty-day incidence of stroke after transcatheter aortic valve implantation: a meta- and network meta-analysis comparing self-expandable versus balloon-expandable valve prostheses

Abstract Introduction Stroke is a major and feared complication after transcatheter aortic valve implantation (TAVI). So far it is unknown, weather the valve deployment system itself has an impact on the incidence of periinterventional stroke. We sought to identify the incidence of 30-day stroke after transfemoral TAVI with self-expandable (SE) and balloon-expandable (BE) valves and performed a meta- and network meta-analysis to analyze differences related to the valve deployment system. Methods Overall 2706 articles were searched comparing directly the performance of SE and BE TAVI valves, from which 7 were included for analysis (one randomized controlled trial, 6 propensity score matching studies) with a total number of 2488 patients. Meta-analysis used random effects model and reported risk ratios (RRs). To compare different type of valves a random-effects network meta-analysis based on a frequentist framework for indirect and mixed comparisons was applied and reported odds rations (ORs). Using P-Score the relative ranking probability of each valve was estimated and the hierarchy of competing valves was obtained. Results Thirty-day incidence of stroke was 1.9% in SE (22 out of 1139, Medtronic CoreValve, Medtronic Evolut R and Pro, Boston Scientific ACURATE neo and St. Jude Medical Portico) and 3.1% in BE TAVI valves (42 out of 1349, Edwards Sapien 3 and XT) resulting in a RR of 0.65, (95% confidence interval (CI) 0.51 to 0.82). In accordance with the estimated P-Score CoreValve was the best effective for a reduction of 30-day stroke (72,5%) whereas the worst were Sapien 3 and XT (19.%). Combined direct and indirect evidence showed no superiority of CoreValve compared with Sapien valves (OR 0.469, 95% CI 0.13–1.64) concerning 30-day stroke incidence. Conclusion Our meta-analysis indicates a higher thirty-day incidence of stroke after TAVI with BE valves compared to SE valves. Furthermore, we could not find evidence for superiority of a specific valve system. Randomized controlled trials with head to head comparison of SE and BE valves are needed to address this open question. Funding Acknowledgement Type of funding source: None